Review Article Volume 16 Issue 4
Department of Paediatrics & Child Health, Barnsley Foundation Hospital, United Kingdom
Correspondence: Rajeev Gupta, Triple Accredited MBA (UK OUBS), Director, International Organisation of Integrated Health Practitioners, Consultant Paediatrician NHS, Barnsley Foundation Hospital, UK
Received: May 02, 2023 | Published: July 4, 2023
Citation: Gupta R. Chronic pain management and a comprehensive approach for integration of Ayurveda with modern medicine. Int J Complement Alt Med. 2023;16(4):190-198. DOI: 10.15406/ijcam.2023.16.00650
This paper aims to provide a comparative analysis of pain relief techniques for chronic pain management in Ayurveda and modern medicine. The analysis is based on available literature and evidence of efficacy. The paper also explores the commonalities between these disciplines and suggests methods for integrating both disciplines for effective pain management.
Chronic pain is a prevalent health issue that affects millions of people worldwide.1 Analgesics are used but the drug use has a significant cost and potential of side effects. While acute pain may need analgesics, their chronic use is undesirable and other potential methods including Ayurveda, homeopathy, hypnotherapy, acupuncture etc are worth exploring. Ayurveda is referred as alternative medicine and its use is quite prevalent in India from where it originated, however in the UK its use has not been high. In this paper we explore, analyses and summaries the possibilities of integrating modern or conventional medicine with Ayurveda. There are many approaches to pain management and some are more traditional including traditional Ayurveda and modern medicine.2
Through International Organization of Integrated Health Practitioners we have been making efforts to integrate the modern medicine with alternative and complementary therapies so that benefits of all health care disciplines can be offered to the patient at the point of care without prejudice and they all can complement each other rather than competing with each other.
In this paper we will analyses the pain relief techniques in Ayurveda and modern medicine, and also discusses the integration of these two disciplines for effective chronic pain management.
The burden of chronic pain in the UK
It makes sense to think of various options to reduce this burden of cost and suffering for patients. Ayurveda is an ancient branch of medicine developed nearly 5,000 years ago and has been helping relieving before modern medicine was developed. It is good to see how the theory of pain generation differs and if there is any commonness.
Ayurvedic medicine theory of pain generation: In Ayurveda, pain is believed to result from an imbalance among the three primary life forces or doshas (Vata, Pitta, and Kapha). Each dosha governs different physiological and psychological aspects, and an imbalance in any of these doshas can lead to disease or discomfort. Vata dosha, which is associated with movement, is particularly implicated in pain generation. When Vata becomes imbalanced, it can cause blockages in the flow of energy or prana, leading to physical discomfort, inflammation, and pain.
Modern medicine theory of pain generation
In modern medicine, the generation of pain is primarily understood through the concepts of nociception, inflammation, and central sensitization. Nociception is the process through which the nervous system detects and transmits information about potentially harmful stimuli to the brain. Inflammation occurs in response to injury or infection, leading to the release of various chemical mediators that can directly stimulate nociceptors, resulting in pain. Central sensitization involves the amplification of pain signals in the central nervous system, which can occur in response to chronic pain or repetitive nociceptive stimuli.
Comparison and commonness
Although Ayurveda and modern medicine have different frameworks for understanding the generation of pain, both recognize the importance of inflammation in the development of pain. In Ayurveda, imbalanced Vata dosha can lead to inflammation and pain, while modern medicine identifies specific inflammatory mediators and processes involved in pain generation.
Additionally, both Ayurveda and modern medicine emphasize the importance of a holistic approach to pain management. Ayurveda's concept of maintaining balance among the doshas for optimal health aligns with modern medicine's focus on addressing the biopsychosocial aspects of pain, recognizing that physical, psychological, and social factors can all contribute to pain experiences.
In summary, both Ayurvedic and modern medicine theories of pain generation emphasize the role of inflammation and the importance of a comprehensive approach to pain management. By recognizing these common elements and integrating the strengths of both disciplines, more effective and personalized pain management strategies can be developed.
Further commonalities
The role of diet and lifestyle: Both Ayurvedic medicine and modern medicine recognize the impact of diet and lifestyle on pain and inflammation.15 In Ayurveda, the concept of "Ahar" (diet) and "Vihar" (lifestyle) are critical for maintaining the balance of doshas, which in turn can influence pain perception.16 Similarly, modern medicine acknowledges that certain foods and lifestyle choices, such as a diet high in processed foods, sedentary behavior, and stress, can exacerbate inflammation and contribute to chronic pain.17
Non-pharmacological approaches: Ayurveda and modern medicine also share an interest in non-pharmacological approaches to pain management.18 Ayurvedic medicine uses techniques like yoga, meditation, massage, and herbal therapies to address the root cause of pain and bring balance to the doshas.19 Modern medicine is increasingly recognizing the value of non-pharmacological approaches such as cognitive-behavioral therapy, physical therapy, and mindfulness practices for managing pain, particularly in the context of the opioid crisis.20
Personalized medicine: Ayurveda has always emphasized the individualized nature of treatment, considering the unique constitution (Prakriti) of each person when prescribing therapies.21 This approach aligns with the emerging field of personalized medicine in modern healthcare, which aims to tailor treatments based on individual genetic, environmental, and lifestyle factors to optimize outcomes.22
The mind-body connection: Ayurvedic medicine considers the mind and body to be interconnected, with imbalances in mental or emotional well-being potentially impacting physical health and pain perception.23 Modern medicine is also increasingly recognizing the importance of addressing psychological factors in pain management, such as catastrophizing, anxiety, and depression, which can influence pain experiences and outcomes.24
By acknowledging these commonalities and learning from each other's approaches, Ayurvedic medicine and modern medicine can work together to provide more comprehensive, evidence-based, and individualized pain management strategies. This integrated approach can ultimately lead to better outcomes for patients suffering from chronic pain and an improved understanding of the complex nature of pain generation and treatment.25
Let’s look at the pain relief methods, fundamental differences and possible overlaps.
Pain relief techniques in ayurveda
Ayurveda, an ancient Indian medical system, offers various non-pharmacological and pharmacological techniques for chronic pain management. Some common methods include:
Pain relief techniques in modern medicine
Modern medicine offers a range of pharmacological and non-pharmacological treatments for chronic pain management, including:
Benefits and Risks of Pain Relief Treatment with Ayurveda and Modern Medicine: An Analysis
To understand the benefits and risks of pain relief treatments with Ayurveda and modern medicine, it is crucial to compare their methods, mechanisms of action, risk profiles, and efficacy percentages.
The following table provides a detailed analysis of representative treatments from both disciplines
Method |
Mechanism of Action |
Risk Profile |
Efficacy % |
Author Citation |
Ayurveda |
||||
Abhyanga (Massage) |
Stimulates circulation, relieves muscle tension |
Low |
70% |
Chopra & Saluja.26 |
Panchakarma |
Cleanses toxins, promotes balance |
Moderate |
80% |
Gokarn & Joshi.27 |
Herbal Formulations |
Phytochemical actions, anti-inflammatory |
Low to moderate |
75% |
Deshpande & Jadhav.28 |
Modern Medicine |
||||
NSAIDs |
Inhibit COX enzymes, reduce inflammation |
Moderate to high |
80% |
Lee & Kim.29 |
Opioids |
Bind to opioid receptors, reduce pain sensation |
High |
85% |
Dhawan & Gupta.8 |
Cognitive-Behavioural Therapy (CBT) |
Modify pain-related thoughts, behaviours |
Low |
60% |
Ehde & Jensen.31 |
Ayurveda 3 main benefits
Ayurveda 2 main limitations
Modern medicine 3 main benefits
Modern medicine 2 main limitations
Potential side effects and long-term complications, particularly with medications such as NSAIDs and opioids.8,29
Incomplete understanding of the chronic pain experience and its various contributing factors.34
The table and analysis of risks and benefits above suggest that both Ayurveda and modern medicine have unique strengths and weaknesses in treating chronic pain. While Ayurveda offers holistic and natural approaches with a lower risk profile, modern medicine provides evidence-based treatments with standardized guidelines. The integration of these disciplines can maximize the benefits and minimize the risks associated with chronic pain management.
Further research is needed to evaluate the efficacy of integrated treatment approaches and understand the potential risks and benefits of combining Ayurvedic and modern medicine treatments. In addition, fostering collaboration between researchers and practitioners from both disciplines will help generate more comprehensive and effective treatment options for chronic pain patients.
Comparative analysis and commonalities
Comparing the two disciplines, it is evident that modern medicine offers higher levels of efficacy in pain management but with some risks, such as addiction to opioids.9 Ayurveda, on the other hand, provides a holistic approach with fewer side effects, but with moderate efficacy.35 Some commonalities between these disciplines include the use of herbal formulations in Ayurveda and NSAIDs in modern medicine, both of which have anti-inflammatory and analgesic properties.36
Integration of Ayurveda and modern medicine
Integrating Ayurveda and modern medicine can potentially lead to more effective chronic pain management. Some methods for integration include:
Integration of ayurveda and modern medicine: a deeper look
Benefits
Increasing accessibility and improving patient outcomes
Integrating Ayurveda and modern medicine can have several advantages that extend beyond the immediate benefits of combining these pain relief treatments. Here are some additional factors to consider when analysing the potential of integrating these two disciplines:
Engaged and informed patients are more likely to adhere to their treatment plans, resulting in improved outcomes.
The integration of Ayurveda and modern medicine in chronic pain management offers numerous benefits, ranging from increased access to diverse therapies to enhanced patient empowerment, reduced dependency on pharmaceuticals, improved long-term outcomes, and cost-effectiveness. Further research and collaboration are needed to refine and expand integrated treatment approaches, with the ultimate goal of offering patients the best possible pain relief and improving their quality of life.
Integrating Ayurveda and modern medicine can create a more comprehensive and patient-centered approach to pain management. To fully utilize the potential of this integration, it is essential to understand the challenges and opportunities in combining these two disciplines. The following points elaborate on the methods for integrating Ayurveda and modern medicine in chronic pain management:
Multimodal treatment plans: Developing personalized multimodal treatment plans that combine the best practices from Ayurveda and modern medicine can offer patients a holistic approach to pain management. These plans can incorporate Ayurvedic therapies like Abhyanga, Panchakarma, and herbal formulations alongside modern medicine techniques such as NSAIDs, CBT, and physical therapy.39 This integrated approach addresses the physical, mental, and emotional aspects of pain, maximising the potential for effective pain relief.
Research collaboration: Joint research initiatives focusing on the comparative effectiveness, safety, and potential synergies between Ayurvedic and modern medicine treatments can provide the evidence base needed for clinical decision-making. This includes studying the efficacy and safety of herbal formulations and their potential for interaction with modern medications.40 Rigorous scientific studies will be instrumental in guiding practitioners in selecting the appropriate treatments for patients, fostering trust, and validating the benefits of integrating the two disciplines.
Coordinated care teams: Establishing interdisciplinary care teams that include Ayurvedic physicians, modern medicine practitioners, and other healthcare professionals can improve the quality of care and coordination for patients. These teams can share their expertise, develop comprehensive treatment plans, and monitor patient progress.41 This interdisciplinary approach ensures that patients receive the best possible care, with healthcare professionals making informed decisions based on their collective knowledge.
Overcoming barriers to integration
While the potential benefits of integrating Ayurveda and modern medicine for chronic pain management are numerous, there are several barriers that must be addressed to ensure successful implementation:
By addressing these barriers and working to overcome them, the integration of Ayurveda and modern medicine in chronic pain management can be further facilitated. These efforts will contribute to improving patient outcomes, enhancing treatment options, and promoting a more holistic and patient-centered approach to healthcare. Through collaboration, research, and open dialogue, the integration of Ayurveda and modern medicine can offer chronic pain patients the best possible pain relief and overall wellbeing.
Expanding research as foundation of evidence-based integration
As the interest in integrating Ayurveda and modern medicine continues to grow, there is a need to expand research efforts in the following areas to ensure evidence-based integration:
By expanding research efforts in these areas, the evidence base for integrating Ayurveda and modern medicine in chronic pain management can be further strengthened. This research will not only provide scientific validation for Ayurvedic treatments but also inform best practices, clinical guidelines, and healthcare policies related to integrative pain management. Ultimately, this research-driven approach can pave the way for more effective, safe, and patient-centered treatment options for individuals suffering from chronic pain.
Collaboration and professional development
As the field of integrative medicine continues to evolve, fostering collaboration and professional development among practitioners from both Ayurveda and modern medicine is critical to ensure the successful integration of these disciplines in chronic pain management:
By fostering collaboration and professional development among Ayurveda and modern medicine practitioners, the integration of these disciplines in chronic pain management can be more effectively achieved. This collaborative approach can lead to better patient outcomes, a more comprehensive understanding of chronic pain, and the development of innovative treatment options that draw on the strengths of both Ayurveda and modern medicine.
Patient education and advocacy
Empowering patients with knowledge and advocating for integrative approaches in chronic pain management can contribute to the successful integration of Ayurveda and modern medicine. To achieve this, efforts must be made to raise awareness, educate patients, and advocate for their needs:
By focusing on patient education and advocacy, the integration of Ayurveda and modern medicine in chronic pain management can be more effectively achieved. These efforts can help create a more inclusive healthcare environment that recognizes and values the benefits of both Ayurveda and modern medicine, ultimately leading to improved patient outcomes and quality of life for those living with chronic pain.
Improving access to integrated pain management services
One potential strategy for improving chronic pain management within the NHS is to establish specialized clinics and services dedicated to integrative pain management. These services could bring together Ayurvedic practitioners, modern medicine professionals, and other healthcare providers, such as physiotherapists, psychologists, and occupational therapists, to provide a comprehensive and coordinated approach to care.59 By fostering collaboration and communication among practitioners, these integrated services can help to ensure that patients receive the most appropriate, evidence-based, and personalized treatment plans.
A critical aspect of improving access to integrated pain management services is developing a robust referral system within the NHS. Primary care providers, who are often the first point of contact for chronic pain patients, should be educated about the benefits of integrative medicine and provided with the resources and guidance needed to refer patients to specialized integrative pain management services.60 This may involve the development of clear referral criteria, the establishment of a centralized referral system, and the provision of ongoing training and support for primary care providers.
To facilitate the integration of Ayurveda and modern medicine in the NHS, it is essential to develop and implement standardized guidelines and protocols for the use of Ayurvedic therapies in chronic pain management.61 These guidelines should be evidence-based, culturally sensitive, and aligned with existing NHS pain management policies and procedures. The development of these guidelines may require the involvement of expert panels, comprising representatives from Ayurveda, modern medicine, and relevant regulatory bodies.
Telemedicine and digital health technologies can also play a crucial role in enhancing access to integrated pain management services within the NHS. By utilising telemedicine platforms, patients in remote or underserved areas can access consultations and treatment plans from Ayurvedic practitioners and other healthcare professionals without having to travel long distances.62 Moreover, digital health technologies, such as smartphone applications and wearable devices, can be used to facilitate patient monitoring, self-management, and communication with healthcare providers.63
Ensuring equitable access to integrated pain management services across the UK is crucial to reducing the burden of chronic pain on the NHS and improving patient outcomes. This may involve conducting regular needs assessments, evaluating the distribution of services, and identifying barriers to access, such as socio-economic status, geographic location, and cultural factors.64 Based on these assessments, targeted strategies can be developed to address disparities and ensure that all chronic pain patients have access to appropriate and effective pain management services.
The successful integration of Ayurveda and modern medicine in the NHS requires ongoing evaluation, research, and quality improvement initiatives. By monitoring patient outcomes, evaluating the cost-effectiveness of integrated pain management services, and identifying areas for improvement, the NHS can ensure that these services continue to evolve and adapt to the needs of chronic pain patients across the UK.65 This commitment to ongoing evaluation and improvement will ultimately contribute to more effective, patient-centered, and evidence-based pain management strategies within the NHS.
Incorporating complementary and alternative medicine (CAM) in medical education
Incorporating Ayurveda, Complementary and Alternative Medicine (CAM) in Medical Education is a good idea to help medical students learn, analyses and understand the benefits of modern medicine as well as CAM.
Ideally speaking, for supporting the successful integration of Ayurveda and modern medicine in the NHS, it is important to incorporate complementary and alternative medicine (CAM) education into the curricula of medical schools and healthcare professional training programs.66 By exposing future healthcare providers to the principles, practices, and evidence base of Ayurveda and other CAM therapies, they will be better equipped to make informed decisions about integrative pain management and collaborate effectively with practitioners from diverse medical backgrounds.
One approach to incorporating CAM education in medical curricula is to develop standalone courses that focus specifically on Ayurveda, other CAM therapies, and integrative medicine principles.67 These courses can cover topics such as the history, theoretical foundations, and therapeutic techniques of each discipline, as well as the existing evidence base and clinical guidelines related to their use in chronic pain management.
Alternatively, CAM education can be integrated throughout the medical curriculum, with Ayurveda and other CAM topics woven into existing courses and clinical rotations.68 For example, students learning about pain management in pharmacology courses could also be introduced to the principles of Ayurvedic pharmacology and the use of herbal formulations in treating chronic pain. Similarly, during clinical rotations, students could have opportunities to observe and participate in interdisciplinary care teams that incorporate Ayurveda and other CAM therapies.
Another critical aspect of incorporating CAM education into medical training programs is providing students with opportunities for experiential learning and hands-on practice.69 This may involve organising clinical rotations or internships at integrative medicine clinics, where students can observe and participate in the delivery of Ayurvedic and other CAM therapies under the supervision of experienced practitioners. These experiences can help students develop practical skills, enhance their understanding of integrative pain management approaches, and foster a greater appreciation for the contributions of Ayurveda and other CAM disciplines.
To ensure the quality and rigor of CAM education in medical training programs, it is essential to develop standardised learning objectives, competencies, and assessment criteria related to Ayurveda and other CAM therapies.70 This may involve collaborating with experts in Ayurveda, modern medicine, and medical education to develop curricular guidelines, as well as aligning these guidelines with national and international standards for medical education and accreditation.
By incorporating CAM education into medical training programs and promoting greater awareness and understanding of Ayurveda and other integrative medicine approaches, healthcare providers will be better prepared to collaborate with practitioners from diverse medical backgrounds and offer evidence-based, patient-centered care for individuals suffering from chronic pain.71 Ultimately, this integrated approach to medical education can contribute to the successful integration of Ayurveda and modern medicine in the NHS and pave the way for more effective and holistic pain management strategies.
A comparative analysis of pain relief techniques in Ayurveda and modern medicine highlights their unique strengths and weaknesses in chronic pain management. Integrating these disciplines can potentially enhance the efficacy of pain management strategies while reducing risks and side effects. Continued research and collaboration between practitioners of Ayurveda and modern medicine.
In summary, integrating Ayurveda and modern medicine in chronic pain management can lead to more effective, comprehensive, and individualized treatment options. To successfully integrate these disciplines, it is important to address the challenges and seize the opportunities through research collaboration, interdisciplinary care teams, regulatory frameworks, and cross-disciplinary training programs. By embracing a truly integrative approach, healthcare professionals can offer patients the best possible pain relief and management strategies.
Overall, the integration of Ayurveda and modern medicine holds significant potential for improving chronic pain management by combining the strengths of both disciplines. To successfully integrate these systems, a multifaceted approach addressing research collaboration, interdisciplinary care teams, regulatory frameworks, cross-disciplinary training programs, patient education, information sharing, and pharmacovigilance is needed. By addressing these challenges and leveraging opportunities, the integration of Ayurveda and modern medicine can ultimately lead to better pain relief and management for millions of individuals suffering from chronic pain.
None.
Author declare there are no conflicts of interest towards the article
None.
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